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HomeMy WebLinkAbout1837 Main Street (2)Application No. 36 6PermttNo. ......3............................ TO THE BUILDING INSPECTOR of the TOWN OF SOUTH WINDSOR, CONN. hereby make application for a permit to {mew (make alteration to) a building according to the following detailed,statement of the specifications and plans herewith submitted. (Draw a line through word `erect" or words "make alteration to" as the case may require.) All provisions of the Building By-Laws (Sections 2 to 32 inclusive) shall be complied with in the execu- tion of this work whether specified herein or not. South Windsor, Conn.4 7.......:S;........... 19.........`?c Sign here .........................................I............ Address a T, Location? . t ,» ' ......... .............side of? ...... ...... ...1.'............7`;............................. Nearest cross street? ... C.IGd.. .......... . ... . ..6-ttreet No. . .... ....... ........... ................ Lot No. ... ........... ............. . Owner of land is? IGQC!'FJ,,.....R.. ..Address 7;................. ..................... Ownerof building is? .t t Address .. ...... ...... .......................................................................................... Architect is? ....... ..... ................................................... ............... Address ... .................. ............................................ I Builder is? :;:6"Ar.......... ..... P.. A,..Address r....a .. ,o.c. ...... imensions of building? .. Feet front? . .... Feet rear? ...... ....... .......... Feet deep? 6nExtreme height to highest point of roof? ...... ... ............ No. of stories in height? . .. Q Purpose of building is? .. . ...... ..........................................................No. of stores? .... .......... .... .. ... .......................... ........................... Howmany families? ..................................._......_..........................................No. of rooms? ... .. ........ ...... ..... ........................................... ................ Distance from street line is? from building line is? . ADDITIONS AND ALTERATIONS Give Brief Description) 1 .....6,/:,.5............... .... .............. 0000r.................... ........................ d l l ..o ..'............... ........... ...4.. '....C CIJ. ...... ....A, ....... t............. r l V4' .... . ..... .... ................................................ram Map No. .. . ......., If of steel frame, what is exterior construction? . What kind of columns used? .............. . . .. . ..... .. .... .. ........Size of columns used? What length of columns used? ... .How protected? What kind of beams or girders? .. Size of beams or girders? .. Longest span of beams or girders? These rest on? Roof construction is? .......... ........... ... .. ...... ...................................Roof covering is? . The floors are of .... . .... .. construction and are calculated to carry a safe load of lbs. per square foot. See Section 14, Building By-Laws.) BRICK CONSTRUCTION. Of what material will walls be constructed? Compositionof mortar? Height and Thickness of Walls Height Stories Front Walla Side Walls Rear Walls Partition Walls Basement, I...................... 1st Story 2nd " 3rd " I......... •............................... ......... .... .........I................................ ............................................I....................... ......... ...... ..... ... .. .. .... 4th is 5th It 6th " I............... .............................................................................. 7th " 8th 11 9th " 10th " Material.of Front? . If stone, what kind? Thickness of Ashlar?Thickness of Backing? Backed up with what? Arches or lintels over openings? T`'X n WOOD CO S'1'JRMUCTM.I Goo See, Loge S ems. Between Cues, Of G' l C Jo a s Fill 8h* Long"*8PM CeNtM Bdftbg SbO LOMW sPM CA=tM SW in 2nd-...u... _.». ._............................... ................ ...................... ......... N.... .......... ................._............. 4 ........ .................. .................................. »»................ th Size of outside studs? ....................................... Distance on centres? .................... ..............Size of sill.? Size of rafters? .................................... Distance on centres?............................................... Size of plate? ..................................................... Size of ledgers or girts? .............................. ............................................Size of deck rafters? ............ ....................................................a .............. Distance on centres? .............. ........................................................................Size of studs in bearing partitions? .......................................... MISCELLANEOUS Style of roof, flat, pitch, Mansard, or hipped? . .... ....... Fireplaces? ....................................................... Material of Cornice?Material o roof coveruig? . . ........................ ................... How is building heated? ..Lining of flues? ... .......... Thickness of shell of flues? ........... ....................................................Any elevators or lifts? ...................... ... .................. .. ..................... What kind? . ... ..... How many? .... .Any hoistways? . ... How protected? Total Value of Building . . .. ..........o.... When will work be commenced? . 1 l ..................................................................... The applicant warrants that the lot for residential purposes, shown on a plot plan accompanying this appli- cation, has 20,000 square feet, or more, and at least 100 foot frontage on a Town road shown on a map of South Windsor showing Town Roads dated December 1949, or on any other roads officially accepted by the Town of South Windsor since 1949. Applicant 3396 BUILDING APPLICATION 3656 ApplicationNo. . ................................................................ on the .. East ......... side of Maim Street. Street No, Owner Ell swarth Sperry Applicant Gharle s Staiger CLASSIFICATION Additional renovations to house. Permit...#3348 taken out .in .JuZy,,1960. Permit issued on above Application. Jan.3, 61Date, 19 . . TOWN OF SOUTH WINDSOR BUILDING PERMIT Date Jan 3 19 6 3L Fee Paid $ 24 0©),,Est.-Value y$ 6:,.©06' Permit N? 3396 on the East side of Main Street Street No. Owner Ellsworth Sperry Applicant Charles Staiger CERTIFICATE OF OCCUPANCY ISSUED: Date No. Fee Paid CLASSIFICATION Additional renovations to house, Permit #3348 taken out in Julyo 1960 BUILDING PERMIT No 3396 OFFICE OF THE BUILDING INSPECTOR of the Town of South W1 ndsor, Conn. South Windsor, Conn. Jan. s3 19 61 C114t's to to Trrtt jj., That Chaff°les Utaiger is hereby granted permission to L d d i t i onn 1 re n ov n t i o n a to h o i 1 s e. F'e r±j.t 11 3348 taken out in July. 1!960. at estimated value.of $ on the —b;—sast— side of a i., Street on land owned by -,?1Q a r t h Said 14 or to be as described in Application No. 6 6 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Issued Jan, 3-19 61 Building Inspector. Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers during the day and by both barriers and colored lights by night. SECTION 1343, GENERAL STATUTES OF CONNECTICUT: "When any person shall place or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a license therefor from the city or borough in which such highway may be situated, he shall pay said city, town or borough all costs and damages which it shall sustain, or be compelled to reason therefor." 1,7 7153' 6853Ajoication-No. ............................... Pennit'No. .............................. BTO LDM INSPEMR of the TOWN OF SOUTH WINDSOR,CONN. kt-9............ hereby make application for a permit to (mow (make alteration to) a building accorifing to the following detailed statement of the specifications and plans herewith submitted. (Draw a line du=gh word "erect" or words `make alteration to" as the case may requires) All i i of the Building By-Laws (Sections 2 to 32 inclusive) :ball be m%AW with in the ezecu.Provo=$ tion of this work whether specified herein or not. South Winds". Conn. .........X --------------- 19.41F. Sip here .. .........."_ offl....W.. Location? ................................................................. side of? ............... !; Nearest cross:trey tr 1.tAVW.. Street No. .................................................... Lot NO. ................................ Ownerof land is?,7 AAA627..... Ownerof building is? ....................................................................Address ... ............................................................................................................... Architectis? .......................................................................................................-Address .................................................................................................................. Builder 4:4.92M•f IDimensions of building? ..............................Feet front? .............. ............... Feet rear? ................. ........... Feet deep? .... ...... ........ ... Extreme height to highest point of roof? .............. ..... .............. .. ... .. . .... No. of stories in height?...... Purposeof building is? .................................................................................No. of stores? ................................................................................................... Howmany families? ........................................................___-No. of rooirs? .... .................................................................................................. Distance from street line is? ................ ............................................from building line is? .........................I........................................................ ADDITIONS AND ALTERATIONS Give Brief Description) 0700C el.......... .... ..........4__111_&............2................ MapNo. ........... ........ If of steel frame, what is exterior construction? . What kind of columns used? ........................ ........ . . ...........Size of columns used? What length of columns used? ... .. . ... How protected? What kind of beams or girders? .. ......... Size of beams or girders? ..... Longest span of beams or girders? These rest on? Roof construction is? .......................................................................................Roof covering is? The floors are of ......... ............. construction and are calculated to carry a safe load of lbs. per square foot. See Section 14, Building By-Laws.) BRICK CONSTRUCTION. Of what material will walls be constructed? . . ... .. ..... . .. ....... .... .. . ................ . ....... Compositionof mortar? . ................................................................................................................................. .............. ............. ...... .. ... ..... ............ Height and Thickness of Walls Hekht Stories Front Walls Side Walls Rear Walls Partition Walls Basement, 1st Story 2nd " 3rd " r.... ......................I..........................,............................................. .......................................... ,...................... .......................... .............. ......... ..... ...... .. .. 4t'h Is 5th is 6th " I... ............................................. .................................... .......................................................................................................................... 7th 8th is 9th " loth....... ....... . .. ..........-....... ... .......... . ............... Material,of Front? If stone, what kind? Thickness of Ashlar? Thickness of Backing? Backed up with what? Arches or lintels over openings? WOOD CONSTRUCTION. Giv Size, Longest Span and Distance Between Centres, of Joists, Girders and Columns JOISTS GIBDIMS OOLUI MS Floors Size Longest Span Centres Bridging Size Longest Span Centres Sire I.engW Centres 1st Floor a.....;.... ............. ................................. a..... ..... ............. .................................. 4 ......... ............ ................ Size of outside studs? ............. ........... ........ Distance on centres?Size of sill? Size of rafters? ............................ Distance on centres?........ ... ........... .. .............. Size of plate? ..................................................... Size of ledgers or girts? .............I............... ..........................................Size of deck rafters? ................................................................... ............... Distance on centres? ...................................................................................Size of studs in bearing partitions? .................................................. MISCELLANEOUS Style of roof, flat, pitch, Mansard, or hipped? . . Fireplaces? ...................................................... Material of roof covering? . Material of Cornice? ............... ................ How is building heated? . Lining of flues? ... .............................................. ........ . ............. Thickness of shell of flues? ............ ........................................... .......Any elevators or lifts? .................... ........................... ...................... What kind? . ....... ... ....... . .. .. ... . How many? . Any hoistway,9 .. How protected?Total Value of Building ... .....5 +C?................................ I When will work be commenced? The applicant warrants that the lot for residential purposes, shown on a plot plan accompanying this application, conforms to the zoning regulations of the Town of South Windsor. Town of South Windsor since 1949. 7 dr Applicant 6853 BUILDING APPLICATION 153ApplicationNo. ...............7............................................................ east onthe ............................................................................... Side of M.a.i.n....S.t.... ..... .. .... .................. ... Street. Street No, Owner ..Hildred RaymondRaymond Applicant Charles Staiger CLASSIFICATION Rebuild barn and tool shed. Permit issued on above Application. Date, . 9-29-69...... ig .. I TOWN OF SOUTH VVENDSOR may_q4£ BUILDING PERMOrr n Sept.29, 69Dateig Fee Paid 30.00 Est Value . ,59000 Permit N° 6853 on the east side of Main S t. Street Street No. Owner Hildred Raymond Applicant Charles Staiger j CERTIFICATE OF OCCUPANCY ISSUED: i Date No. Fee Paid $ CLASSIFICATION Rebuild barn and tool shed. BUILDING PERMIT N° 6853 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. South Windsor, Conn. sept.299 19 9 94io to to Terttf1j, That is hereby granted permission to Rebuild barn and tool shed. at estimated value of $5 000 on the east side of Main St.Street on land owned by Hildred Raymcmd Said Work to be as described in Application No. 7153 and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. s•pt.29, 69 Building Inspector. Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers during the day and by both barriers and colored lights by night. SECTION 1343, GENERAL STATUTES OF CONNECTICUT: "When any person shall place or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a license therefor from the city or borough in which such highway may be situated, he shall pay said city, town or borough all costs and damages which it shall sustain, or be compelled to reason therefor." TO THE BUILDING INSPECTOR of III APPLICATION FOR TOWN OF SOUTH WI OGM COlW PLAN EXAMINATION ARD BUILDING PERMIT IMPORTANT — Applicant to complete all items in ections: 1, 11, 111, IV, and IX.O e A I. ZONIN AT (LOCATION) DISTRI LOCATION NO.) STREET) OF BETWEEN AND BUILDING CROSS STREET) CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use A A 1 New building Residential Nonresidential 2 Addition(l/residential, enter number 120 One family 18 Amusement, recreationalofnewhousingunitsadded, i/any, in Part D, 13)13 Two or more family — Enter 19 0 Church, other religious number of units— — — — 20 Industrial3 Alteration (See 2 above) 4 Repair, replacement 14 Transient hotel, motel,21 Parking garageordormitory — Enter number 5 Wrecking (If multifamily residential, of units ——————— — — 22 Service station, repair garage enter number of units in building in 15 Garage 23 Hospital, institutional Part D, 13) 16 0 Carport 24 Office, bank, professional6 Moving (relocation) 17 Other — Specify 25 Public utility7 Foundation only 26 School, library, other educational B. OWNERSHIP 27 Stores, mercantile 8 R Private (individual, corporation, 28 Tanks, towers nonprofit institution, etc.) 29 Other — Specify 9 Public (Federal, State, or local government) C. COST Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g., food processing plant, machine shop, laundry building at hospital,elementary 10. Cost of improvement,,,,,,,,,,,,,,,, S j6V school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant.To be installed but not included If use of exi ling building is being changed,enter proposed se. in the above cost s a. Electrical...................... See b. Plumbing ...................... to Yil 24_.-W w CA=42_ ed-- c. Heating, air conditioning......... d. Other(elevator, etc.)............ 11. TOTAL COST OF IMPROVEMENT E III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; for wrecking, complete only Part J, for all others skip to IV. E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 30 Masonry(wall bearing) 40 Public or private company 48• Number of stories................ 31 Wood frame 41 49. Total square feet of floor area,Private (septic tank, etc.) all floors, based on exterior 32 Structural steel dimensions .................... 33 Reinforced concrete H. TYPE OF WATER SUPPLY 34 Other — Specify 42 Public or private company 50. Total land area, sq. ft. ........... 43 Private(well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 35 Gas Will there be central air 52. Outdoors....................... 36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 Electricity 44 Yes 45 No 53. Number of b dr ms. 38 C al 39 Oth r— Specify Will th re be an elevat r? Full.......... 54. Number of 46 Yes 47 No bathrooms partial........ NOTES and Data — (For department use) IV. IDENTIFICATION — To be completed by all applicants Nam Meiling eddr ss — Number, street, city, and State ZIP codeq T I. No. Owner or Lessee O 2. Contractor 3. Architect or Engineer The own r of this building and the undersigned agree to conform to all applicable laws of this jurisdiction. Signature of applicant Address Application date t o-z r Zj DO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans R vi w R quired Check Plan Review Date Plans By Date Plans By NotesFeeStartedApproved BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS P rmit or Approval Check 0 Date Number Number By Permit or Approval Check ObtainedD t Number By BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL SIGN OR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. VALIDATION Building Permit numb r 10036 Building Permit issued Oct_ 31 19 77 Bui Iding Permit Fee A_00 Approv d by: TITLE VIII. ZJNING PLAN EXAMINERS NOTES DISTRICT USE FRONT YAR SIDE (ARD SIDE YARD REAR YARD NOTES IX. 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Y-b.de} -a .. E '°t f"'-JJJ "9 s-, s" {'}`"`t e pAs, ,f q o-- A$•t f .£ '{- }- - 1• s. {.} ti-ta i£. r s s.-3 a s B r-f-4T1tfp i- r-4{i 4" -t-} `t= f-'7'%m- p-1- d.j + y q.{ f .„ . t p rt 'TIT j 1 i; aa ti 4 rtt 1} fi- t} tr t t q 4+Yr arr } { - { i.;a -r it fit ril- Owl y b IR S« t .E44 1. 4-f 7 14 Ii q r l }• slitV$f 1 i Spa f i txaM440.'T-04"'R±M MtjQ 40043111f z TOWN OF SOUTH WINDSOR BUILDING PERMIT Date nC t 31 19 7 7 Fee Paid ,$. .3..00 Eat. Value $.2-00L.00 Permit N® 10036 on the aide of Main S t Street Street No. 1837 i Owner Hildrpci Ravmnnci Applicant Hi 1 d re d R aymam r, i CERTIFICATE OF OCCUPANCY ISSUED: Date No. Fee Paid $ CLASSIFICATION Fence BUILDING PERNWr NS 10036 OFFICE OF THE BUILDING INSPECTOR of the Town of South Windsor, Conn. Oct. 31 7Z South Windsor, Conn. 19 Hildred Raymond Z4' to to #"V!XfgteTnhcae as shown on map. is hereby granted permission to 200.GO Main St. at estimated value of $ on the side of Street on land Hildred Raymond owned by Said Work to be as described in Application 10336 No. and to conform to specifications and plans filed with said Application, and Building By- Laws of THE TOWN OF SOUTH WINDSOR. Oc t . 3 1 77 Ids 1 10 AF din "Inspector. Streets and sidewalks, obstructed by excavations or building materials, must be guarded by barriers during the day and by both barriers and colored lights by night. SECTION 1343, GENERAL STATUTES OF CONNECTICUT: When any person shall place or keep building materials, or any obstacle in any highway (or any sidewalk) either with or without a license therefor from the city or borough in which such highway may be situated, he shall pay said city, town or borough all costs and damages which it shall sustain, or be compelled to reason therefor." JPA1177 77e-..I-.s;ZK- Y9 -z INSPECTION REPORT Permit #1NM Job 1 Footing 2 Foundation 3 Framing r a7 :7 4 Wiring 5 Plumbing 6 Heating 7 Lathing 8 C.O. 8041 ELECTRICAL APPLICATION Application No. 9198 on the side of Main Street Street No. 1-8 37 Owner Hi ldreel Raymond Electrician Petersen. Eler'triC FILED IN OFFICE OF The Building Inspector July 26 19 83 INSPECTION. No Electrical Work shall be started until a Per- mit is granted by the Building Inspector. In New Buildings no wiring shall be started until the plumbing and heating pipes, and the fire stops (if of wood) are installed, without a special permit from the office of the Building Inspector. APPLICATION FOR PERMIT TO DO ELECTRICAI. WORK. No. ..... ........5.8... ...... Permit No. . .... 0+ ..........,. TO THE BUILDING INSPECTOR of the TOWN OF SOUTH W INDSOR, CONN. j hereby make application to, perform Electr cal Work according to detailed description below. All provisions of the Rules for Electrical Installation, Section 48, Building BpJjws, shall be complieo with whether specified herein or not iCSouthWindsor, Conn., ... 19 Sign here L. Address 1% a 1";' tJ. ( 'Location Side of .. . Nature of Building rX2 How many stories ...... . .... .....,,7...................................... ................ New or old Building How many families ..............................1W........................................................ Kind of Installatio How many Stores ........................................................................................ ... Owner .............. ..... . ..../..I.. ........'.S'!................... ....... ..... .... Address ......!' Architect Address . . . ..... ..... . . ................................................ Builder 1 1. Address 45Electrician X . ... Address Size of Main Wires .. .... ........... No. of Light Loops No. of Heat Loops . .... No. of Power Loops .................. ....._._......... No. of Light Outlets . ....... ... No. of Heat Outlets . . No. of Power Outlets ................ ............. NoP of Light Circuits . . .... . .... .. ..... No. of Heat Circuits No. of Power Circuits No. of Sockets No. of Heat Receptacles No. of Motors ......... .. .. No. of Panels ................ ... ......... . . . Size of Heat Circuit No. of Power Receptacles No. of Switches ... ..... . ... .. Total Wattage . . .. ...... Size of Power Circuit Total Horsepower No. of Straight Electric Fixtures .....No. of Combination Fixtures ... . No. of Receptacles ........................ .... ... ........................ .. No. of Cord Drops ...... .............. . ........... ........ ............ .... .... .. Remarks: For other kind of Installa ... .... . ........ .................... . ............. ... ... ............................... ..... w .. . ....t. f. r .... ........._......................... Estimated Cost .... .... ... ... ............... ..... 8434 ELECTRICAL APPLICATION Application No. RRRA 9840 on the side of i Street Street No.1837 Owner Hildred Raymond Electrician A la n P P t P r_-qP n FILED IN OFFICE OF The Building Inspector June 26 19$4_ INSPECTION. mNo Electrical Work shall be started until a Per- mit is granted by the Building Inspector. In New Buildings no wiring shall be started until the plumbing and heating pipes, and the fire stops (if of wood) are installed, without a special permit from the office of the Building Inspector. Electrical Permit No. w....................... Master License No. A.. ...0-:5.......... TOWN OF SOUTH WINDSOR Building Permit No. .1,0i12.. ........................ BUILDING DEPARTMENT Date Filed ....i Ailt-x........................................ Date Final Approval ................. ........................... APPLICATION FOR ELECTRICAL WORK Electrical Inspector JOB LOCATION: JOB OWNER:41... Sideof BetwS* ... and ................................................................................. VNameofBuildingOwner4px,"D ......1. 4 e4xv.WZx.),Z Address If work is for Lessee—Give name Address ............... .... ........................ .............. ....... ................. Building now occupied as (unless n No. of family units now Building to be occupied as Number of family units to be ...... ............ . Is this work included in a Building Permit? Permit Fee .. ..... ......... ..... .. ... .................................................... ........ ........... If no Buildir erm*t) eiW 07:2 -,27- TelephonePermitteeA4644eC54- 6 46' -f C usiness Address,/,; 46A COSTOF INSTALLATION:I.......................................................................................................................... TO BE FILLED OUT BY PERMITTEE TO BE WIRED EXISTING APPLIANCES Number of light outlets to be installed Number of convenience outlets to be installed Number of present Appliance Circuits ... ................... ... ..... Number of switches to be installed Do these include Range Water Heater Number of appliances to be installed as listed below) Dryer Air Conditioner E] Oil Burner TYPE RATING NO. Dish Washer Gas Burner Range . . . . . . . . Well Pump Elec. Heaters Range Top . . . . . . Oven . . . . . . . . REMARKS: Water Heater . - . . I Clothes Washer . . . . Clothes Dryer . . . . . Dish Washer . . . . . . Air Conditioning Motor . Oil Burner Motor . . . . Gas Burner . . . . . . Circulator Motor . . . . Attic or Large Fan . . . Well Pump . . . . . . Electric Heat . . . . . Other . . . . . . . . . Number of new Lighting Circuits . . . . ............................. Number of new Appliance Circuits . . . ............................. Number of Heating Circuits . . . . . . ........................... Number of Motor Circuits . . . .&6. . ............—"'--Size of present service ........... .....;I!y.10.............................................Sizeof service to be . ... .................. ....-Z................................. PERMIT DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT H 9 7 # Application is hereby: TOWN OF SOUTH WINDSOR APPROVED DISAPPROVED BUILDING INSPECTION DEPT. 644-2511 Ext. 230 g'-7-91 Application must be printed or typed . Date 4Bu - ing Inspector 1. LOCATION OF JOB 04:z 1"I-,qltv -921503 FEE SCHEDULE No. Street 0 - $19000 - 10.00 Floor Apt . No. Over $1,000 - 10.00 per $1 ,000 or 2 . OWNER /QD ,Q j' qy&-6vin> fraction thereof o 3. ADDRESS S70,- 4. APPLICANTa--7e- -A-7-:Fz--A-2 5. ADDRESS 6. ESTIMATED COST $d 7 . IS THIS A CONTRACT COST Yes No 8. FEE ENCLOSED $ 10 9. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL 10. TYPE OF JOB : Original Installation Alteration/Addition/Repair BD 3A 11/88 APPLICATION FOR ELECTRICAL PERMIT I from Reverse Side) 11 . LOCATION OF JOB y / I%IAI) NO. STREET APT. NO , 12 . TYPE OF INSTALLATION 13 . SIZE OF MAIN FEEDER 2 92 Q 4ol 14 . NO . OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS 16 . NO. OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS 18 . NO . OF HEAT CIRCUITS 19 . NO. OF POWER OUTLETS 20. NO. OF CONVENIENCE OUTLETS l 21. NO. OF HEAT CIRCUITS 22 . NO. OF POWER CIRCUITS 23. NO. OF LIGHT CIRCUITS 24 . SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS 26 . NO. OF PANELS 1- 27 . TOTAL WATTAGE 28 . NO. OF POWER FEEDERS 1 29 . NO. OF SWITCHES 30. A/C LOAD 31. SIZE OF POWER FEEDERS 32 . NO. OF FIXTURES 33. TOTAL HORSEPOWER 34 . NAME OF SUBCONTRACTORS AND THEIR TRADES 35 . REMARKS AND FURTHER DETAILS : NS i G G .S'iF'y<G U 0t+ /74eoU. LICENSE NO.SIGNATURE OF APPLICANT DATE PHONE NUMBER: Lot No. Building Permit VAM C T mporary Service Permanent Service Pursuant to Permit No. This Certifies that the Electrical Work for which the above named PLarmit was granted has been duly Inspected and Is hereby approved. Owner Electrician Street Z 19LL A Building Inspector B ildLngNSPECT 4 APPLICATION FOR BUILDING PERMIT Plumbi HVAC Date: Sprinkler 1837 MAIN STREET Electric Estimated Cost $ Zoning 22150 Permit Fees • _ Affidavit NO.Occupancy Fee $ Eng. Dept.COMPLETE RED BOXER AREAS.Fire Dept. Total Fee $TYPE OR PRINT O LYHealthDept. SIGN ON REVERSE SIDE.Approved for CO: Additional Cost) $ TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT The and rsi ned, herebv aoolies ta7do work according to the following specifications: Job Location 37 /Y1/I f N_S Lot No. Side of Street Zone Applicant Awl/ /¢/ s Tel. # 96 ` _3-3-_ Address 4 5 3 S/E ST 1A/a0i0 o/ Zip 06a i/ Lic.# SOc>S9O TREET CITY STATE Owner c2m-f'-4 ,1- )3/l,l Address Architect Address Size New Area: Ft. Front Overall Ft. Deep Overall Total Area Garages LavatoriesSizeofLotDist. from Street Line Bathrooms Roo s 1st 2nd 3rd Purpose of this Permit S'X;w /,vs'7' ,C, CV.N? /- u/r,,Q p City Water D Well 13 Septic 0 Sewer 0 Use Group xJ Construction Type Approved by 2 Date 8D1A 11/88 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines and required distance om all other zones and is located in a zone in which this building and its use is allowed. Signed I hereby apply for a Certificate of Occupancy for the work described in this applicati f er Signed DO Nor WRITE BELOW THIS LINE- INSPECTION RECORD Footing Framing Foundation Fireplace/Chimney Insulation Plumbing Permit# Inspections: HVAC Permit# Inspections: Electrical Permit# Inspections: Sprinkler Permit# Inspections: s<r- FOR OFFI E USE ONLY APPLICATION FOR HVAC PERMIT DATE: Daw, a et 44 NO,. TOWN OF SOUTH WINDSOR EST«CO T: a a_ & v BLDG. PERMIT N0. R 1540 SULLIVAN AVENUE FEE W e SOUTH WINDSOR, CT 06074 FEES: Je2r 644-2511 - Ext. 230 0 - $19000 - $10.00 1000 or fraction LOCATION 'OF BUILDING 3 j/f/f yU C,Te120-T thereof - $10.00 J?U ID40 MQA' P JA4 y-t-W6 0 1/01cz OWNER ADDRESS TOWN PHONE NO. HVAC CONTRACTOR ADDRESS P TOWN PHONE NO. TYPE OF SYSTEM: HEATING TYPE OF BUILDING: RESIDENTIAL A/C COMMERCIAL VENTILATION BUSINESS INDUSTRIAL IF HEATING: STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT -- LBS. HYDRONIC__.k_WARM AIR -- UNIT RADIANT HEATER (INCLUDING WOOD/COAL BURNING STOVE) TYPE OF FUEL: OIL-GPM a•iy GAS IN-PUT ELECTRIC KW WOOD COAL OIL TANK - SIZE & LOCATION: INSIDE _ OUTSIDE CAPACITY 4 I1Crv- LPG TANK - CAPACITY EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE . -*F INSIDE OF DIFFERENCE --OF TOTAL HEAT LOSS (BTUH) HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT (INCLUDING MAKE b MODEL NO.}: (A,,14,_ ^off4 j ri RL 37%- Lv 7`6 p1iu TC Oe%T / iw 13 Lc r' I1K f 91/an rKT0v(.. G Go/-mn e GROSS HEATING CAPACITY (INPUT-BTUH) NET RATING (OUTPUT-BTUH) IF AIR CONDITIONING: DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT GAIN (BTUH) HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT (INCLUDING MAKE & MODEL NO.): TONNAGE COOLING CAPACITY (BTUH) IF VENTILATION: DESCRIBE ALL AIR-HANDLING EQUIPMENT (INCLUDING KITCHEN EXHAUSE EQUIPMENT): TOTAL SIZE OF SYSTEM (CFM) FRESH AIR INTAKE (CFM) PLAN MUST ACCOMPANY APPLICATION) The undersigned hereby applies for a permit to perform the following work and is to comply with all local ordinances and State of Conn. Building Codes in the performance of such work. FURTHER DESCRIPTION OF WORK: Qujlpo, ®Qc 0""TO AT X/'Q w STATE LICENSE - NAME & TYPE #DATE 6nGNATURE OF APPLICANT 110'q APPROVED DATE I - B - R CALCULATION SHEET 1503 (Modern Method)Copyright 1977 by The Hydronlcs institute OWNER ADDRESS DESIGN TEMPERATURE DIFFERENCE F. DATE C L A COL.S COL.C COL.D COL.E COL.F COL.G 1 ROOM Q O H L W H L W H L W H L W H L W Design Water Temp. 2 ROOM DIMENSIONS, FT.U STUN pair F of of 3 LENGTH EXPOSED WALLS,FT. Radiation selected 1 WINDOW AND OUTSIDE DOOR AREA IL STUN STUN BTUH STUN STUN 5 WALL CONSTRUCTION ROOM LIN. FT.OF I Table 9, Line 3 x H)TOTALS RADIATION 6 TYPE OF GLASS FROM LINE 12 SELECTED 8 ttom of table used for Line 51 7 CEILING CONSTRUCTION C Table 9.L x W) B FL(YRO CONSTRUCTIONt O— Table 9, L x W or LIn F t) E 9 COLD PARTITION CONSTRUCTION F ITable 9, L x H)G 10 C 1 Wall(With Openings)O C; 2 Wells(With Openings) S Xi3Wells(With Openings)or Ent.Hell J 11 TOTAL BTUH AT 70F TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE K COL.A —COLS COL.H COL.1 COL_J COL.K COL.L. TOTAL BTUH TOTAL 1 ROOM OF BUILDING RADIATION AT SELECTED O H L W H L W H L W H L W H L W DESIGN TEMP.* 2 ROOM DIMENSIONS.FT DIFFERENCE U 3 LENGTH EXPOSED WALLS, FT 1 WINDOW AND OUTSIDE DOOR AREA LL STUN STUN STUN BTUH STUN 5 WALL CONSTRUCTION INCREASE BATHROOM IT able 9,Llns 3 x NI TOTAL 20% d TYPE OF GLASS Gott m f table used 1 r Line 51 7 CEILING CONSTRUCTION tFOR CONCRETE FLOOR ON GROUND OR FILL AT Table 9. L x WI GRADE LEVEL,USE LINEAR g FLOOR CONSTRUCTIONt FEET OF EXPOSED EDGE Table 9.L x W r Lin Ft l 9 COLD PARTITION CONSTRUCTION 1 Table 9, L x H) 10 c 1 Wall(With Openings)0 0 2 Wells(With Openings) p X 3 Wells(With Openings) or Ent Hall F J - 11 TOTAL BTUH AT 70F TEMP DIFFERENCE' 12 TOTAL BTUH AT DESIGN TEMP DIFFERENCE FORM 1503 This form Is available from The Hydronics Institute.35 Russo Place,Berkeley Heights,N J 01922 z INSPECTOR 1 TE l! TIME LOCATION I INSPECTION:CODE: RESULT D/A : F BUILDING: ELECTRICAL: f PLUMBING: HVAC: r OTHER: cz-d tom, s f Bectric# APPLICATION FOR BULDING PERMIT Plumbing# 1837 MAIN STREET HVAC # 2 4 4 8,5. Dot Sprinkler# No. F7ionvOgh Estimated Cost 471 i COMPLETE RED BOXED AREAS Permit Fee 0?<4 E54 TYPE OR PRW ONLY Occupancy Fee $ Affidavit SIGN ON REVERSE SIDEAppr.for CO.Total Fee TO BULDI IC'DEPARTMENT,TOWN OF SOUTH W QSOR,CT itional Cost) $ The undersigrred hereby applies to do work according to the following specifications: Job location Z 3 Lot No. Side of Street Zone Applicant_// o<.lC' Tel#JAd Address A& lv44V S7—Zip 4Vid Lic.# Owner, 11QF% /p l// 1_Addresse Z .1 l!%s/s /4 r/ ' Architect Address Sq.Ft.New Area: 1st Fl 2nd Fl 3rd Fl Total New Area Rooms Lavatories Bathrooms Garages Purpose of this permit:_ Pro cqs/2._/D r.f i5.../ Gty Water Well Septic System Sewer Ins. H.O. S.P. Cert. Area Basement Garage Approved by Date Use Group Construction Type Rwsed 1/97 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required distances from all other zones and is located in which this building and its use is allowed. Signed I hereby apply for a Certificate of Occupancy for the work described in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS ajoes 1)&ZdjotOSULLIVANAVENUE • SOUTH WINpSa ft CoMM_ 0S*74 AREA CODE 2M/644.2= Ysston cafe: TION FOR CERTIFICATE OF APPROPRIATENESS y made for issuance of a Certlf icate of• , Appropriateness21ishinganHistoricDistrictwithintduoTorteofsw* for proposed work as described below and as shown onphotographsandPionsordravinp (where dppl lcable,, a iscPas x. Address:rff KIN(s) of Mer(s):bdillb ptij address of Omer(s); Address of proposed work: 4911"r r Agent or Contractor: e." ''G0 's ` Address: Naturepanddescriptionon of proposed work: (include plan o •photos) if possible, and elevation drawing where necessary.) Enclosed is a copy of Ordinance and9 • t this Application. Use applicable Statutes which you should review in filling out pp ed. You will be notified of areversesidehereofand/or additional pages if ne ed hearing date. J Proposed f nt of work:p date o cammenceme Estimated copletion date: re of ASignatureofOwnerSignatureApplicant Signature of Owner wwwwwwwwwwwwwwwMrwwwwrwwwwwwwwwrwrwswarwrwwwwwwwwwwwwww wwwwwgwwwwwwwwwwwww rw• FOR COMISSION USE ONLY: Application No. Approved: Date Received:Denied:logo Onto: N-, Will's TO 3E)Vd 0809W 86808Z9098 Z5:60 T00Z/90/90 a t DART 'T'DECISION APPLICATION FOR ELECTRICAL PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: gBUILDINGDEPARTMENT APPROVED 1540 SULLIVAN AVENUE 644-2511 ext. 230 Bldg.Permit# D Building InspectorY r Application must be printed or typed FEE SCHEDULE Location of Job: 0,$1,000=$13.00 Street No. Street Lot No. Over$1,000= 13.00 per$1,000 or mW fraction thereof Tenant Designation Apt.No. APPLICANT AfI eor-/?000fw APPLICANT ADDRESS APPLICANT PHONE# y3 2--0 Z-3 S' OWNER sus o-,•.p OWNER ADDRESS F:33 7 •4.w S,Yc OWNER PHONE ESTIMATED COST$ ,SC,:, gr-- 4 IS THIS A CONTRACT COST? Yes -11q- FEE ENCLOSED$ a, , TYPE OF JOB: M a New Installation a-ICIteration/Addition/Repair Revised 5101 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? YES NO UlE-SIDENTIAL BUSINESS CURRENT USE AND OCCUPANCY ASSEMBLY MERCANTILE FUTURE USE AND OCCUPANCY ,t c s EDUCATIONAL INSTITUTIONAL ENGINEER'S NAME PHONE FACTORY STORAGE ADDRESS GARAGE MIXED USE CITY STATE ZIP TYPE OF INSTALLATION/WIRING METHOD SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? YES NO NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK lijliC iliCccJ .svci/lorr,r./ O/ /C/l'Z'/iC/ THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. 5-1- /83zer e"7 T CONTRACTORS LICENSE NO. E STATE SIGNATURE OF APPLICANT DATE e!9V 7—al DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT# Application is hereby:TOWN OF SOUTH VaNDSOR LO Fc2aBUILDINGDEPARTMENT PR VBD 1540 SULLIVAN AVENUE Bldg.Permit# oJ6/ 644-2511 ext. 230 02 F0 9 ate Building Inspector Application must be printed or typed Location of Job: FEE SCHEDULE 0-$1,000=$13.00 Street No. Street Lot No. Over$1,000= 13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT t T APPLICANT ADDRESS Q SS APPLICA 1P Q 00.00 OW N S F,4 OWNERE: "4vint.I OWNER ADDRESS to 114 OWNER PHONE 57a 8 2 C ESTIMATED COST$ IS THIS A CONTRACT COST? 13 Yes eo FEE ENCLOSED$ n Z) TYPE OF JOB: SpR.CO 0 New Installation Or-Alteration/Addition/Repair Revised 8/99 APPLICATION FOR PLUMBING PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? YES NO RESIDENTIAL BUSINESS CURRENT USE AND OCCUPANCY vi ASSEMBLY MERCANTILE FUTURE USE AND OCCUPANCY IM EDUCATIONAL INSTITUTIONAL ENGINEER'S NAME PHONE FACTORY STORAGE ADDRESS GARAGE MIXED USE CITY STATE ZIP TYPE OF INSTALLATION SIZE OF MAIN DRAIN NO.OF TOILETS STYLE NO.URINALS STYLE NO.OF BATHTUBS NO.OF SHOWERS NO.OF LAVATORIES NO.OF CONDUCTORS SIZE NO.OF STACKS SIZE AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS NO.OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW YES NO SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER: TYPE MANUFACTURER DESCRIPTION OF WORK l r O yi op-'J ochr THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. p4- CONTRACTORS LICENSE N TYPE SATE SIGNATURE OF A DATE a' Y`wDVARTWM DczsloN APPLICATION FOR HVAC PERMIT PERMIT# h is hreby:TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT 1540 SULLIVAN AVENUE Bldg.Permit# k 644-2511 ext. 230 Mft Wpecwr Application must be printed or typed Location of Job: 1 /ii DUSLE 0_$1,000—$13.00 Street No. Street Lot No. 1,000= 13,00 per$1,000 or ,r f Tenant Designation Apt.No. APPLICANT C G_ L-K APPLICANT ADDRESS Q.t-SSAk . R`APPLICANT PHONE#S OWNER441 OWNER ADDRESS Ire K, 01 kit CL OWNER PHONE -jj-qqS2— aw" ESTB"TED COST$ r= IS THIS A CONTRACT COST? O Yes 0<0 y,FEE ENCLOSED$ dtTYPE OF JOB: i ' O New Installation CF Alteration/Addition/Repair Revised 8/99 APPLICATION FOR HVAC PERMIT (Continued from reverse side TYPE OF SVSTEM: TYPE OF BUILDING: Q'HEATING RESIDENTIAL A/C COMMERCIAL VENTILATION INDUSTRIAL HEATING U S EAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. E HYDRONIC WARM AIR UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE_°F INSIDE_°F DIFFERENCE OF TOTAL HEAT LOSS(BTUH)L l LZSG-F(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) GROSS HEATING CAPACITY(INPUT—BTUH) NET RATING(OUTPUT BTUH) TYPE OF FUEL OIL—GPM OIL TANK LOCATION :INSIDE OUTSIDE CAPACITY GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW AIR CONDITIONING DESIGN TEMP.OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT GAIN(BTUH) HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.) TONNAGE COOLING CAPACITY(BTUH) VENTILATION DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT) TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM) PLANS MUST ACCOMPANY APPLICATION) FURTHER DESCRIPTION OF WORK n 1w J r n( 7,(w J,0,0- C)cjt r A THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. CONTRACTORS LICENSE NO. TYPE ST TE SIGNATURE OF APPLI I 1,t llL, DATE % 112g) O( r ` AUG-13-2001 MON 01:15 PM ALLIED PLUM SUPPLY FAX N0, 2334660 P, 02/02 I DR FIF AY Lt1F:ir. C;F';!_CULA T l ON ii 100 3s oa/) "./01 ALL T ED C.ONT RACA-1 Of -L.IN 171,` ) 3?Y :t T1..1_ '. 013 RE Mill, qT,'1 I,IV'f. :3+„t..1Eil E2OOM NAME. F=AC;TOR ROOM 61ZE:' - - BTL.I L00,S- FT 1 f DDI TION 00 213X. If?171x 1.0 11 00- V3. 'F D11114.NSIONAL DATA SQ1. F7 so.F.r ISQ1. F111 SQ. F1' t:1.1, FT t i: rat:T" WALL I;L_ a X' C:r l_ F:' f=1,:l... L'[11..I1fii;._ - I..Z V.: WILL. 1-138S G1.F;CSS Cf:a 1.1 NG, . . F1 10R) - - INV ILTRAI 1.f_114 Ti:.1TP .--13-J.ii_.__.. 1 1.41 1 0 3220. 80, 80.1b. 00 640. 00 5 t 4 Q E C')'f fal i 14 .1. : c'-:r::+71. 84 Fi171 1. + 4 . 41 1 811 e.0 rrfE: V1: L--tt_i PFK feirl. F''1'. OF L IV1Nf-': A.REA IS cif•;. e'l - W:. AVt A'1_yE O YU PER CJ1J. F—T. OF LIVING M,c.iA 113 j FACTORS USEU IN CALCULATION BTU\f=T AC rt R WAI..L_31.A; r: i.i roc - FU313n t NI:r1_'r; r]ITM JT . .-T(-.'M1- a43 'm iR. 001). 0G 0. (;1 fay.._ . . 0 04 414. r........,, ....., ..... ....M+yww.ki...r.._ a.... ._... ......r.;w.pa..r._....r.w.w..l.w.._,_w-.,... _ ._...._w+_-+......._........-......._..-.++•+.+... —. DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: Z/C YyBUILDINGDEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 Date Building Inspector Application must be printed or typed FEE SCHEDULE Location of Job: 3 0-$1,000=$13.00 Street No. Street Lot No. Over$1,000= 13.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT 4 l C.c-t/S At LICANT ADDRESS l C S c/4f APPLICANT PHONE# CJ90I 5 - — Ow owNER OWNER ADDRESS Af 3 7 i'//o[r 4 01, OWNER PHONE ESTIMATED COST$ 1,a000 ao r ' IS THIS A CONTRACT COST? O Yes Na y1 FEE ENCLOSED$ 317. d o OR CO TYPE OF JOB: w Installation 13 Alteration/Addition/Repair Revised 5101 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: 01 HEATING a-tESIDENTIAL A/C COMMERCIAL VENTILATION INDUSTRIAL HEATING STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. HYDRONIC E AARM AIR UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING E UIP NT(INCLUDING MAKE&MODEL NO.) GROSS HEATING CAPACITY(INPUT BTUH) NET RATING(OUTPUT—BTUH) eW TYPE OF FUEL MOIL--GPM o,MOIL TANK LOCATION:INSIDE OUTSIDE CAPACITY GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW AIR CONDITIONING DESIGN TEMP.OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT GAIN(BTUH) HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.) TONNAGE COOLING CAPACITY(BTUH) VENTILATION DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT) TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM) PLANS MUST ACCOMPANY APPLICATION) FURTHER DESCRIPTION OF WORK e iG L THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. 36t3'off z S C7-- CONTRACTORS LICENSE NO. STATE SIGNATURE OF APPLICANT